Lesion distribution after cryoballoon ablation and hotballoon ablation: Late-gadolinium enhancement magnetic resonance imaging analysis
Lesion distribution after cryoballoon ablation and hotballoon ablation: Late-gadolinium enhancement magnetic resonance imaging analysis
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DOI：
10.1111/jce.14073
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发表时间：
2019-07-23
影响因子：
2.7
通讯作者：
Hirata, Ken-Ichi
中科院分区：
文献类型：
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作者：
Akita, Tomomi;Kiuchi, Kunihiko;Hirata, Ken-Ichi
低温球囊消融（crobloon ablation， CBA）后肺静脉隔离（Pulmonary vein isolation， PVI）病变广泛且持续，但其分布与肺静脉大小有关。我们试图评估CBA和热球囊消融（HBA）后病变分布和PV大小之间的关系。方法与结果共纳入80例连续行PVI的患者（40例为CBA）。病变通过晚期钆增强磁共振成像可见。评估病变宽度、病变间隙以及从PV口（PVos）到病变远端边缘（DLE）的距离。如果DLE扩展到PV内部，则该值表示为负值。虽然CB组的病变宽度明显更宽（7.8 +/- 2.0 vs 4.9 +/- 1.0 mm, P < 0.001），但HB组的病变间隙数量明显更少（2.9 +/- 2.4 vs 1.3 +/- 1.4间隙，P = 0.001）。两组PVos到DLE的距离均为负值，但影响更大（-1.5 +/- 1.8 vs -0.2 +/- 1.2 mm, P < .001），且与CB组PV大小呈负相关，而HB组无此关系（r = -0.27, P = .007）。手术后12个月房颤复发率无差异（CB组40例中有5例[12.5%]vs HB组40例中有4例[10%]，P = 0.695）。结论与CBA相比，HBA后的PVI病变具有(a)变窄，但(b)更连续，(c) PV内病变较小，(d)与PV大小无关。
Introduction Pulmonary vein isolation (PVI) lesions after cryoballoon ablation (CBA) are wide and continuous, however, the distribution can depend on the pulmonary vein (PV) size. We sought to assess the relationship between the lesion distribution and PV size after CBA and hotballoon ablation (HBA). Methods and Results A total of 80 consecutive patients who underwent PVI were enrolled (40 with CBA). The lesions were visualized by late-gadolinium enhancement magnetic resonance imaging. The lesion width, lesion gaps, and distance from the PV ostium (PVos) to distal lesion edge (DLE) were assessed. If the DLE extended inside the PV, the value was expressed as a negative value. Although the lesion width was significantly wider in the CB group (7.8 +/- 2.0 vs 4.9 +/- 1.0 mm, P < .001), the number of lesion gaps was significantly less in the HB group (2.9 +/- 2.4 vs 1.3 +/- 1.4 gaps, P = .001). The distance from the PVos to DLE was a negative value in both groups, but the impact was significantly greater (-1.5 +/- 1.8 vs -0.2 +/- 1.2 mm, P < .001) and negatively correlated with PV size in the CB group, but not in HB group (r = -0.27, P = .007). The AF recurrence 12 months after the procedure did not differ (5 [12.5%] of 40 in the CB group vs 4 [10%] of 40 in the HB group, P = .695). Conclusions The PVI lesions after HBA were characterized by (a) narrower, but (b) more continuous, (c) smaller lesion inside the PV, and (d) irrespective of PV size as compared to that after CBA.